4493 Mallard Tr NINSPECTI4N RECORD ?°?t?°' "°. 0144
CIfiY 4F EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. G** i?A
Eagan, Minnesota 55123 Date Issued: e3 / 3 t/
(612) 681-4675
SITE ADDRESS: to T: r
4493 MAILARU TR N
1 NOMAS LAKE WOUUS
PERMIT SUBTYPE:
. f l?w(i
APPLICANT:
WtNSMAMM PkOPERTIES
(612) 623•--1179
TYPE OF WORK:
M ew
INSPECTION
, i Y F. .. .
PU t) 1 J N"
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FpAMiMH IMSUtA'i IfJN
41A! 1 ROAR1.1 FYNAL
F tR Er?iact -
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Permk No. PsnnR Holdsr Dsta Telephane i
S/W
PLUM8ING
J
HVAC
ELECTRI
ELECTRIC
Mapeetlon Daft M". Commsnts
Footngs I
Foundetlon
rc
Framiny
Roo6ng
B-vh pbg. __ xg
R°ugh Nfg' ?g
Isul.
F'eplace ur ? YZ
,ok
F+na' "tg.
Orsat Test
Fkal Plbg. 064 Plbp. frrspeoEar - NotNy Plumber
Const. Meter
EngrJPlen
Bldg. Flnat
Dedc Flp.
Declc Finel
Weil
Pr. Disp.
s ?
? ? ? • .?
(gerftfir?te uf (Orrupanry
Citp of Cagan
mr}rarbow af 1ufild'mg jnwrtiatt
?7ris Cerirfficate rssued pursuanl W the raguireinenis ojSection 306 of rhe Uniform &rtlding
Cade cernfying tleat at Ae time of issuarrce this srruclure was in conrpliance w}1h 1he mtous
ordinances ojthe City regulating building cons7nuxion or use For the followdng:
use clmdfiaLdw SF DWG/GAR Bft rawk lib. 123
00-PM"TM R-3 M-1 Zooing Dbbicl R-1 Tya Co"L Vn
owworemum iJENSHANN PROPERT1E;5A",v 14340 PILOT KNOB RD.,ApPLE VALLEY
&"w AM" 4493 MALL.ARD TB N Lam* L7, b4, THOMAS LAKE WOODS
A6-?-? &,,j D&W MAY za. 1492
offiew s
POST IN A CONSPICUOUS PUCE
Addres's: 4493 MALLARD TR N Lot 7 Blk 4 Sec/Sub THOMAS LAKE WOODS
These items were/were not complete at the time of the final inspection.
Date: '1- ' Vw- :2__ Yes No ?
Fina1 grade (6" from siding) ?
Permanent steps - garage
Permanent steps - main entry ?
Permanent driveway
Permanent gas ?
Sod/seeded grass L/
Trail/curb damage ?
Porch ?
Basement finish
Deck
Please verify wlth the builder the removal of roof test caps from tha plumbing
system and tha shut-off of watar supply to the outside law faucet before
freeze potential exists. ?
uoam,..E.
White - City copy Yellow - Resident copy PSnk - Contractor copy
/03/ 71
°°
ReQUes? Date Fra No Rough-inlnSpecLOn
C
2 Reqmretl'+ ? Ready Now gl Will Notity Inspec[or
3/16/9 52 ves ? No wnen aeaav+
I iK licensed contractor ? owner hereby request inspection of above electrical work et:
Job AOOress (Sireet. Box or Rovte No.) Ctly
4493 Mallard Trail Eagan
$ecLOn No Township Name or No Range No CouMy
Dakota
Qmpanl (PRINp Phone No
Wensmann Properties 423-.1179
Pawer SuOPlter AtlEress
w??
yq.?' ?,?nnn MaXI•iP?? TTo+.r_D?v?4 11RTT
J
Electncal Contracmr (COmpany Neme) Contraaor§ License No
Joos Electric Co. CA00961
Maihng Atltlress tConVactor or Owner Making Installalmn) t-
2104 Great Oaks Drive, Burnsville, MN 55337 l
ANhonzed SgnaNre ICOnUactouPxner MaWng In9all PM1One Numbei
431-4755
MINNESOTA STATE BOAHO OF ELECTNICITY THI$ INSPECTION REOUEST WILL NOT
Griggs-MlOwey Bldg. - Room S473 ? BE ACCEPTEO BY THE STATE BOARD
1621 UniversHy /.ve., 51. Vaul, MN SS1W UNLESS PFOPER INSPECTION FEE IS
Plwne(611)662-0800 ENCIOSED
REQUEST FOR ELECTRICAL INSPECTION
? Sae instmctions lor completing iM1ls lorm on Oack of yellow copy
J.28575 "X" Below Work Cariered by This Requesl
EB-00001.00
a?"4 9
ew Adtl Rep TypeofBwltling AppliancesWired EqwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Budding Dryer O[her (Specdy)
Comm /Industnal Fumace
Farm Air Condi[ioner
Olher (specily) Comractor5 Remarks
Compute lnspeclion Fee Be/ow
# Other Fee # ServiceEntranceSrze Fae # Circwts/Feeders Fee
Swimming Pooi 0 to 200 Amps 0 to 100 Amps 47
Transformers Above 200 _ Amps A _ Amps
SIgnS Inspector5 Use Only ? OTAL
Irngalion Booms ?? • $ 6 5. 5 0
Special InSpec[ion
Alarm/Communication THIS INSTALLATIO Y BE ORD R ONNECTED IF NOT
Other Fee COMPLETED WI B mQmyHjf r
I, the Electrical Inspector, hereby Rough-in ? oeiaj-/ JY
e
certify that Ihe above inspection has
6een made Final oW
OFFICE USE ONLY
Tnis reQUast wd! 18 months Irom
INSPECTION RECORD C°nt °"°. 0144
CITYOFEAGAN PERMITTYPE: euiLoiwG . ,
3830 Pilot Knob Road Permit Number: 000123
Eagan, Minnesota 55123 Date Issued: 03 / 31 / 92
(612) 681-4675
SITEADDRESS: LoT: 7
9493 MALLARD TR N
THOMAS LAKE WOODS
PERMIT SUBTYPE:
SF OWG
BLOCK: 4 APPLICANT:
WENSPfANN PROPERTIES
(612) 423-1179
TYPE OF WORK:
NEW
INSPECTION
SITE .. .
FOOTZNG .A
FRAMING INSULATION
WALLBOARD FINAL
FIREPLACE
REpIARK5: RECEIPT q
?
PRV WENZEL
?
' PERMIT C°n ° "° 0144
F EAGA
CITY O N
. PERMITTYPE: BUILDIN6
3836 Pilot Knob Road
Number:
Permit
000123
Eagan, Minnesota 55123 Date Issued: 0 3/ 31 / 9 2
(612) 681-4675
SITE ADDRESS:
4493 MALLARD T R N
10T: 7 BLOCK: 4
THOMAS LAKE WOODS
DESCRIPTION:
Permit Type
Building_ SF DW6
_
Building Work Type NEW
UBC Occupancy., R-3 P9-1
Construction Type VN
Zoning
? VN
Building Length 53
Building Width 38
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REMARKS:
RECEIPT N C b' o(J(p 3 3I31k Z- PRV WEN2EL
FEE SUMMARY:
VALUATION
;isi,eee
8ase Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
=816.00
E531.70
$75.50
$700.00
100
$2,125.20
MISC FEES $1.610.50
Total Fee $3,735.70
CONTRACTOR: - Applicant - ST. MNER:
WEN3RIANN PROPERTIES 14231199 0001 56 WENSMANN PROPERTIES
14340 PILOT KNOB RD 14340 PILOT KNOB RD
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 423-1179 (612)423-1179
I hereby acknawledge that I have read this epplication and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
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APPLICANT ERMITEE SIGNATURE ISSU BY: IGNATURE
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( 1992 BUILDING PERMIT APPLICATION
''l '-?? - ? 681-0675
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0DENaT65 UZowl Flnof-?UMENT
I hereby certify that this survey was prepared by me or
, under my direct supervision and that I am a duly Registered
;Land Surveyor under the laws of the State of Minnesota.
Date -4?
LeRoy H ohlen
Registered Land Surveyor No. 10795
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_ a_ a.??-Total• wa11-:w'indocr_ area _._?__._.... --•.....,...... Z3`?
- - - 1'.==_To'taY door. area ................ ................. ..... _... ...,.... . . ca
:. t.=a?otal`.sl??,i.ng.glass door aLea.........__.__.....,.
3.` -To}a2 fireplace. wall. area
va ............... . .. _....... _?
?. E: ?'TotaL ll.1tami.ng• aiea -(ayerag?= lOR) ...... __ . Z I?{
: _ 'f= :.'Total .net wall- area :above :floor ..... _.. .. .. .. 1 L
.. -g. ToCal rim joist area .......................... L
_ Total e:cposed foundation area = 3?Y3
h. Total foundation window area .................. 4
? i._,Satal net..faundatiaa area- above grade
•- DeDeCerniine.,IL"'_vaYu?sf: eacli wa?f .segment.
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3 . ...............................Total = 2!0% .1?! ,;-
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If item "v3 is the same as, or less Chan item ?71, you have met the inter.t
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.. sq
. ft. x
2. Total roof/ceiling area . 13/7 sq. ft. x,p?l, _ .?1-• Z
J
To
tal
e:cpos
ed
wall
are
a
above floor
?
? ? w. . ? '
• -
?. .
1-1
?=?ll terri at e Buildino. yz'.n,ve Iap.t ?4e s i gn
To utilize the totaZ envelope systen nethod, the values established by
Che sum of items 03 and C4 shall not be greater than the sufl oi itecs
91 and #2.
1
+ 2, _
- --+ 4.
I
Page 2 of 2
Total exposed roaf/cei!ing area
j. Total skylight area ...........................
k. Total roof/ceiling fraaing area (average 107.)..
1. Tota1 net insulated roof/ceiling area ......... I/Afe?_
Determine "U" value for each rcaf/ceiling segment.
J. ot x „Ult _ (:?7 -
k. 132 x,lIIit z&
? i. I 1?5 xflUf, ? vz ? 9 =?5, 9S
4 ..........................................Tota1 = Z / 1
If total of iF4 is the same as, or less than 02, you have em t the intent
. -..?. :.:of-ssc-:6ca6(c)1.
. Q.
-2-
CITY OF EAGAN FOR CZTY USE ONLY
3830 PIIAT KNOB ROAD
• EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # OS?
"M"Mp DATE: -S 8 90?--
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-----------------------------------------
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME: V-U
SITE ADDRESS: LI
LOT:__z_ Nhm_C6 CK / SUBD, i1?(1N2QlJ?/Y?. INSTALLER: bc
ADDRESS• t
CITY: Tb.O 15 ZIP: 5?y
TURE OF PERMITTEE
COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CLOSET 3.00
SATH TUB 3.00
LAVATORY 3.00
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
_ HOT TUB/SPA 3.00
_ WATER HEATER 3.00
_ FIAOR DRAIN 3.00
CA5 PIPING CL'T.
_ (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
1< WATER SOFTENE 5.0 -?'
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE s S-D .50
TOTAL: $
?
EOMMERG,IAI;f?iJSTRIAIis PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WtiEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
__-- ° ----------------------°-
CONTRACT PRICE:
pUnigu pTA14E:
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZiP:
PHONE #:
FEES
1$ 0° rnpTpnrT FFE,
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 16
STATE SURCHARGE
TOTAL:
(SIGNATURE)
FOR:
CITY OF EAGAN
CITY OF EAGAN
L/' B y? MECHANICAL PERNIIT RECEIPT #/d S/9
SUBD. 1 / (612) 6814675 DATE . ? /9 ,1--
RESIDEIVTIAI.
PLEASE COMPI.EI'E UPPER PORTTON ONLY FOR SINGLE FAMII Y DWELLINGS. AISO, COMPLEfE FOR
TOWNHOMES/CONDOS WHEN SEPARATE PERAiITS ARE REQUIRED FOR EACH DVVELLING UNIT.
OWNER: FEFS
SITE ADDRFSS: ADD ON(REMODEL (F.XISTING
CONSfRUCfION ONLI) $ 15.00
INSTALLER: GED]Z-RYAN HF4TING AVAC: 0.100 M BTU 24.00
PHONE #: 423-1144 ADDITIONAL 50 M BTU 6.00
ApDgESS; 14745 South Robert Trail GAS OI117.EI'S • bIINIIMUM 1@ $3 EA.
":'!'.': F.csemcunt GIP7 JIOEJS SUKCAARGE: $ .50
SIGNATURE TOTAL: $
?
r
COMMERCIAL
PLEASE COMPLE!'E THIS PORTION FOR ALL COhiMERCLIUINDUSTRIAI. BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI•FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
FACH DWELLING UNTf.
R'ORK DESCRIPTION: CONTRAGT PRIC&
196 OF CONTRAC7' FEE. FEES
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMTT FEE.
$
PROCFSSID PIPING • $25.00
MIIdIMUM FEF. - S25.09-
S
OWNER: TOTAL• $
S1TE ADDRESS:
TENANT: ,:. . . .. , _. . ,. ,:- : : ,: .:.. .
SUI7'E #:
INSTALLER: ,
ADDRESS: ,. .
CI1'1': ZIP:,
PHONE #: CITY SIGNATURE:
SIGNATURE:
G1TT ur r.nunn rux ViTx ubt unLr
3830 YILOT RNOB ROAD
EAGAN, 1SN 55122 PERMIT k
YHONE: (612) 454-8100 RECEIPT
?°3AM8INC,;,???T DATE:
??D?NTIAI.:'. PLEASE COHPLETE IIPPER YORTION ONLY FOR SZNGLE FAMILY DWELLINGS 6
TOWNHOMES/CONDOS WHEN PERMITS AEE REQIIIRED FOR EACB IINIT.
-------------------
UORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
COMPLETE THE FOLLOWING:
N0. FIXTURES F.A. TOTAL
ADD-ON MINIMUM 15.00
] SHOWER 3.00 .00
WATER CIASET 3.00 9.00
BATH TUB 3.00 •??
IAVATORY 3.00 /9.60
KITCHEN SINK 3.00 T60
? IAUNDRY TRAY 3.00 ?QQ
HOT TUB/SYA , 3.00
? WATER HEATER 3.00 3.06
FLOOR DRAIN 3.00 3,00
? GAS PIPING OUT.
(N.INIMU!? - 1) 3.00
...3 ROUGH OPENINGS 1.50
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
Jr?• 50
SUSTOTAL $
ST. SURCHARGE .50
TOTAL: S S3 00
OWNER NAME:
SITE ADDRESS : '/ 3 7&&Aa- .?L
IAT:7' BIACK ' SUBD.
INSTALLER: A?/'?"?O
ADDRESS: 1gSi
CITY: G?-? ZIP: SJ`??oZ o2
PHONE #: ?cSaZ-/SGS
OF
CP34fERCI4jiND1TSTRiAt:; YLEASE COMPLETE THIS PORTION FOR ALL COHMERCIAL/INDUSTRIAL BUILDINGS AND
KULTI-FAMILY SUZLDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER
ADDRESS:
CITY: ZIP:
YHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STRTE SURCHA.?GE - $.50 FQR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRAGT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
?- 9d,Cd
AkL_
Clty of EalaIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax; (651) 675-5694
2008 RESIDENTIAL
.
Date: Site Address: ? _
RESIDENT / OWNER
Address! Ciry I Zip:
Applicant is: _ Owner ? Contractor
IYPE OF WORK I Description of work:
Construcdon Cost: _
CONTRACTOR I Name:
Phone: S4tG,l -&f'/(!/ -/(LrQ?
Multi-Family Building: (Yes_I No
? License#: ????II 1
Address: 'An`II ! I If%?)(X-IUrl TWl Iv.
Cily: &H ? I GL`Yk?r' State: ML!_ ZP: 55
Phone:t0?l'L1;9 •"1,?v ContactPerson:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Catenorv 1 Minnesota Rules 7872
Energy Code • Residerrtial Ven4lation Category 1 Woricsheet • New Energy Code Worksheet
Category Suominea suanitted
(4 su6mission type) • Energy Envelope Calculations Submined
In the lest 72 moMha, haa the City ot Eagan issued a permN for e Similar plan besed on e master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
i hereby acknrnvletlge that this infomnadon is compleOe and axurate: thst the wak wltl be in conformance with the ordinances and cotles of the City ot
Eagan; thal I understand this is not a pertniG bN only an applicfltion tor a permlt, anG work i5 not to StaR without a permit lhat the work will be in
aaordance wiM the approved plan in the case W work which requires a review and approvel of plans.
x_ffla eell) X U?7, ??
Applicant's Prin Na? ApplicaM's Sig ure
v Page 1 of 3
?& 2Z
----------------- ;
?
j Pem?i[#: ? I
i Permit Fee: LlV ??) '- I
I
? Date Feceived: I
i ?
I Stafl: ?
I
BUILDING PERMIT APPLICATION
Suite #:
5 _ qd _
gq of Ealan
3630 Pilot Knob Road
Eagan MN 55122
Phone:(651) 675-5675
Fax: (651) 6755694
Address I Cdy I Zry:
2008 RESIDENTIAL BUILDING PERMIT APPI,.ICATION
tw.• 4'slakJoB s-ft
9
sul%
RESIDENT 101NNER
TYPE OF WORK
CONTRACTOR
Applicant is: _ Owner 4X_ Conuactor
a Qo?
?---------------- ;
i Pemd#:
?
; P"«:_- ?
?
; ome aecei,rea:
I Staff: ?
I-_--------------?
phone: L$f- ?LBra-?lo??
Description of work: R E- 5i b E
Construction Cos't: ?I a.OL>. J
Mu{MFamily Building: (Yes _ I No -Kj
L License 4II4
Ciry:,???L?`Yk?2? _Sffite: _!_ iA-ZP:_ 55Q?
Phone: ?n?` • y?f?•"I ?J Contact Person: _ kQren
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minneoots Rules 7670 Qateaorv 1 Minnesota Rules 7672
Energy Code . Reaidai6ai vena'ta6on coegory 1 Worksneet . Mew Energv Coda waksheet
Catogory Submitted
(J su6mission type) • ? lW CateWadam SubmiUed
In ihs les[ 12 mentMs, has tho City M Ea9M iseusd a pe+mit Mr a almilaz ptan based on a manter Plan?
_Yes _No If yes, date and address of maater plan:
l.icensfld Pfumber: Phone:
Meehanieai Contractor. Phww'
Sewer & water Convactor.
. ........? .. _.. ------ ,_. _ ._.. .
f hereq' dOUWWW9e thaz tlus iMwm1100 a canplete and aara0e:4w Vie work wiD ba in eanformarwe v!M the orc6nanoa8 arM cotles ot ihe tttW ot
Eagan; that 1 understand Mis [s'rot a permN, but ony an sppiicetlon fu a permit, and worlc is not ro stert whhout a Pee^3; tlu[ ft 'N°Ac'MB 6e in
accaoance v(A the approved Wan In the ease m wvAc which requ4es a review arb appravaJ of Pim•
xM - C? rn m t,tCA- xYYI ,
ApPiicaM's Printed Nama ApplicanYs Sigrroture Pepe t of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA122519
Date Issued:05/09/2014
Permit Category:ePermit
Site Address: 4493 Mallard Tr N
Lot:7 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-04-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bruce Schulzetenberg
4493 Mallard Tr N
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160009
Date Issued:02/06/2020
Permit Category:ePermit
Site Address: 4493 Mallard Tr N
Lot:7 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-04-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bruce Schulzetenberg
4493 Mallard Tr N
Eagan MN 55122
(651) 206-2356
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature
r-
For Office Use
EAGAN
3830 PILOT KNOB ROAD l EAGAN, MN 55122-1810
(651) 675-5675 l TDD: (651) 454-8535 I FAX: (651) 675-5694
bi ildingnspections a,cityofeacianocom
Permit #:
Permit Fee: % 3 •
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 8/24/20 Site Address: 4493 N Mallard Trail
J
Unit*:
Cc
d n
ni"_:
Name: Bruce Schulzetenberg Phone: 651-236-2356
4493 N Mallard Trail, Eagan MN 55122
Address / City / Zip:
Applicant is: Owner Contractor
Type of #York ,.
Description of work: Replace existing overhead garage door on attached garage.
Construction Cost: 1000.00 Multi -Family Building: (Yes / No ✓ )
Contractor
Company: AA Garage Door Contact: Dave Sands
Address: 562 Lundy Lane City: Hudson
State: WI Zlp.: Phone: Email. 54016 651-702-1420 : davel'aagaragedoor.com
License #: Lead Certificate #: NAT 671642
if the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE Ppublic lnfanmai`i ions aidi irtllunnatien maybe
cla lfleat a# non trb#c Ifyou perm+/dra specific nt+asarts fhat wauid lt tip City to tonal t t at #
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
CALL. BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. `gym � i
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and app al plans.
XDeborah Nyasende
Applicant's Printed Name
App icants Signature